77 巻 (2018) 2 号 p. 64-68
Objective: Aortitis syndrome with bilateral canal paresis: a case report.
Patient: A 48-year-old man with aortitis syndrome is presented. The patient had no history of vertigo or dizziness.
Result: The patient experienced hearing loss on the left side and dizziness during the investigation for fever of an unknown origin. Sensorineural hearing loss on the left side and nystagmus beating toward the right side were detected with otological examination. Furthermore, a thoracic and abdominal enhanced CT scan revealed a thickened aorta wall, and the patient was diagnosed as having aortitis syndrome. The inner ear disorders were considered to be related to the aortitis syndrome and corticosteroids were administered. Hearing loss was completely restored, but oscillopsia during head movements persisted. A monothermal caloric test showed bilateral canal paresis. Both cervical and ocular VEMP showed no response bilaterally, indicating the dysfunction associated with bilateral otoliths. The results of a video head impulse test revealed decrease in the gain of the vestibule-ocular reflex and appearance of catch-up saccade bilaterally, indicating bilateral canal paresis.
Conclusion: In this case, the inner ear disorder was considered to be related to the patient's aortitis syndrome. Although hearing loss improved, vestibular impairment persisted. Bilateral canal paresis was demonstrated by vHIT, as well as the caloric test.